Applied Physiology in Intensive Care Medicine (eBook)

Introduction 5
Contents 6
Contributors 9
Physiological Notes 15
Intrinsic (or auto-) PEEP during controlled mechanical ventilation 17
Intrinsic (or auto-) positive end-expiratory pressure during spontaneous or assisted ventilation 20
Work of breathing 23
Interpretation of airway pressure waveforms 27
Measurement of respiratory system resistance during mechanical ventilation 29
Understanding wasted/ineffective efforts in mechanically ventilated COPD patients using the Campbell diagram 33
Dead space 37
The multiple inert gas elimination technique (MIGET) 41
Alveolar ventilation and pulmonary blood flow: the V A/Q concept 49
Mechanisms of hypoxemia 53
Pulse oximetry 56
Effects of body temperature on blood gases 60
Venous oximetry 64
Relation between PaO2/FIO2 ratio and FIO2: a mathematical description 67
Hypoxemia due to increased venous admixture: influence of cardiac output on oxygenation 71
Pulmonary vascular resistance 75
Pulmonary artery occlusion pressure 79
Clinical significance of pulmonary artery occlusion pressure 83
Pulmonary capillary pressure 87
Ventricular interdependence: how does it impact on hemodynamic evaluation in clinical practice? 91
Cyclic changes in arterial pressure during mechanical ventilation 94
Lactic acidosis 98
Defining acute renal failure: physiological principles 102
Hypotension during intermittent hemodialysis: new insights into an old problem 107
Intracranial pressure 112
Intracranial pressure 116
Neuromonitoring in the intensive care unit. Part I. Intracranial pressure and cerebral blood flow monitoring 120
Neuromonitoring in the intensive care unit. Part II Cerebral oxygenation monitoring and microdialysis 129
Physiological Reviews 136
Fluid responsiveness in mechanically ventilated patients: a review of indices used in intensive care 138
Different techniques to measure intra- abdominal pressure ( IAP): time for a critical re- appraisal 147
Tissue capnometry: does the answer lie under the tongue? 162
Noninvasive monitoring of peripheral perfusion 171
Ultrasonographic examination of the venae cavae 182
Passive leg raising 186
Sleep in the intensive care unit 191
Magnesium in critical illness: metabolism, assessment, and treatment 201
Pulmonary endothelium in acute lung injury: from basic science to the critically ill 214
Pulmonary and cardiac sequelae of subarachnoid haemorrhage: time for active management? 227
Permissive hypercapnia — role in protective lung ventilatory strategies 239
Right ventricular function and positive pressure ventilation in clinical practice: from hemodynamic subsets to respirator settings 249
Acute right ventricular failure–– from pathophysiology to new treatments 258
Red blood cell rheology in sepsis 270
Stress-hyperglycemia, insulin and immunomodulation in sepsis 280
Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury 289
Matching total body oxygen consumption and delivery: a crucial objective? 298
Normalizing physiological variables in acute illness: five reasons for caution 308
Interpretation of the echocardiographic pressure gradient across a pulmonary artery band in the setting of a univentricular heart 315
Ventilator-induced diaphragm dysfunction: the clinical relevance of animal models 320
Understanding organ dysfunction in hemophagocytic lymphohistiocytosis 330
Seminal Studies in Intensive Care 341
Manipulating afterload for the treatment of acute heart failure 342
Nosocomial pneumonia 346
The introduction of positive endexpiratory pressure into mechanical ventilation: a retrospective 353
Elastic pressure-volume curves in acute lung injury and acute respiratory distress syndrome 357
The concept of “baby lung” 365
The effects of anesthesia and muscle paralysis on the respiratory system 374
Diaphragmatic fatigue during sepsis and septic shock 383
The use of severity scores in the intensive care unit 390
Oxygen transport— the oxygen delivery controversy 396
Organ dysfunction during sepsis 403
Ventilator-induced lung injury: from the bench to the bedside 415
Remembrance of weaning past: the seminal papers 425
Interactions between respiration and systemic hemodynamics. Part I: basic concepts 434
Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care 444
Index 452